Coronavirus: Planned surgery cancelled in Wales

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Planned surgery is to be cancelled in Wales as the NHS gears up to tackle the coronavirus outbreak.

Cutting back on so-called “elective” operations – those waiting for non-urgent treatment – had been put forward as one of the likely options as the pandemic escalates and more patients with the virus need treating.

Non-urgent outpatient appointments will also be put on hold.

Waiting time targets and monitoring arrangements are also being relaxed.

Meanwhile, Welsh Rugby Union chairman Gareth Davies has defended the decision to postpone Wales’ Six Nations game with Scotland, just 24 hours before kick-off.

Also, Cardiff City have confirmed a player and member of staff are self-isolating as a precaution, while a Wrexham FC player has been told to self-isolate after seeking medical advice, with the team’s weekend game against Barrow postponed.

Health Minister Vaughan Gething said: “I am choosing to act now before we see a significant surge in demand so that our services can be ready to act. A larger number of people requiring high levels of care is highly likely over the coming weeks.”

He stressed that access to cancer and other essential treatments such as kidney dialysis would continue.

The minister said the priority was to save as many lives as possible, with 25,000 deaths in Wales possible in a worst case scenario.

Meanwhile, PHW reported 13 new cases, taking the total to 38, including first cases in Anglesey and Flintshire.

Where are the latest cases?

• Four more in Caerphilly county
• Two in Swansea
• A first positive test in both Anglesey and Flintshire
• One each in Cardiff, Carmarthenshire, Monmouthshire, Newport and Powys

A total of 945 people have now been tested.

What actions have been outlined?

• Suspending non-urgent outpatient appointments to ensure urgent appointments were prioritised
• Suspending non-urgent surgical admissions and procedures – but ensuring access for emergency and urgent surgery
• Prioritising the use of non-emergency patient transport to focus on hospital discharges and ambulance emergency response
• Expediting discharge of vulnerable patients from acute and community hospitals
• Relaxing targets and monitoring arrangements across the health and care system
• Minimising regulation requirements for health and care settings
• Fast-tracking placements to care homes by suspending the current protocol which gives to right to a choice of home
• Giving permission to cancel internal and professional events, including study leave, to free up staff for preparations
• Relaxing contract and monitoring arrangements for GPs and primary care practitioners
• Suspending NHS emergency service and health volunteer support to mass gatherings and events

EASY STEPS: How to keep safe

With the peak believed to be 10 to 14 weeks away, First Minister Mark Drakeford said it was about making the “right decisions at the right time”.

Earlier on Friday, the Welsh Government hinted at the move, saying it would need to consider reducing planned activity.

There are currently about 390,000 referrals waiting for hospital treatment in Wales – including some patients on multiple waiting lists. These include 47,000 orthopaedic referrals.

There were also 3 million outpatient appointments in the past year.

This could mean some quite big operations, including heart surgery, will be postponed for people – particularly if patients require intensive care afterwards.

But clinical decisions will have to be made if the conditions of patients deteriorate as they wait and they become emergencies.

We are used to seeing the temporary cancellation of planned surgery used as a pressure valve in the NHS by individual health boards, to relieve demand during winter pressures.

But in the wake of this crisis and the anticipated demand, to see this directed centrally by NHS Wales, is unprecedented.

Darren Hughes, director of the Welsh NHS Confederation, said: “We would ask members of the public to help by being patient and understanding staff are working tirelessly.

“It is important to remember that we all have a responsibility to take precautions to minimise the chances of catching or spreading Covid-19”.

On Wednesday, a senior intensive care consultant warned about the supply of beds and staffing, because critical care units normally work at more than 90% capacity.

Dr Jack Parry-Jones, Welsh board member for the Faculty of Intensive Care Medicine, said Wales was “uniquely at risk” if there was a surge of very sick people.

He said options included cutting back on routine surgery and turning operating theatres into extra intensive care facilities.